Intestinal Immune Responses to Type 2 Oral Polio Vaccine (OPV) Challenge in Infants Previously Immunized With Bivalent OPV and Either High-Dose or Standard Inactivated Polio Vaccine

J Infect Dis. 2018 Jan 17;217(3):371-380. doi: 10.1093/infdis/jix556.


Background: The impact of inactivated polio vaccines (IPVs) on intestinal mucosal immune responses to live poliovirus is poorly understood.

Methods: In a 2014 phase 2 clinical trial, Panamanian infants were immunized at 6, 10, and 14 weeks of age with bivalent oral polio vaccine (bOPV) and randomized to receive either a novel monovalent high-dose type 2-specific IPV (mIPV2HD) or a standard trivalent IPV at 14 weeks. Infants were challenged at 18 weeks with a monovalent type 2 oral polio vaccine (mOPV2). Infants' intestinal immune responses during the 3 weeks following challenge were investigated by measuring poliovirus type-specific neutralization and immunoglobulin (Ig) A, IgA1, IgA2, IgD, IgG, and IgM antibodies in stool samples.

Results: Despite mIPV2HD's 4-fold higher type 2 polio D-antigen content and heightened serum neutralization profile, mIPV2HD-immunized infants' intestinal immune responses to mOPV2 challenge were largely indistinguishable from those receiving standard IPV. Mucosal responses were tightly linked to evidence of active infection and, in the 79% of participants who shed virus, robust type 2-specific IgA responses and stool neutralization were observed by 2 weeks after challenge.

Conclusions: Enhancing IPV-induced serum neutralization does not substantively improve intestinal mucosal immune responses or limit viral shedding on mOPV2 challenge.

Clinical trials registration: NCT02111135.

Keywords: human challenge; inactivated vaccine; live oral vaccine; mucosal immunity; poliovirus.

Publication types

  • Clinical Trial, Phase II
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Neutralizing / analysis*
  • Antibodies, Neutralizing / blood
  • Antibodies, Viral / analysis*
  • Antibodies, Viral / blood
  • Feces / chemistry*
  • Female
  • Humans
  • Immunity, Mucosal
  • Immunoglobulin A / analysis
  • Immunoglobulin D / analysis
  • Immunoglobulin G / analysis
  • Immunoglobulin M / analysis
  • Infant
  • Intestinal Mucosa / immunology*
  • Male
  • Poliomyelitis / immunology
  • Poliomyelitis / prevention & control*
  • Poliovirus Vaccine, Inactivated / administration & dosage
  • Poliovirus Vaccine, Inactivated / immunology*
  • Poliovirus Vaccine, Oral / administration & dosage
  • Poliovirus Vaccine, Oral / immunology*


  • Antibodies, Neutralizing
  • Antibodies, Viral
  • Immunoglobulin A
  • Immunoglobulin D
  • Immunoglobulin G
  • Immunoglobulin M
  • Poliovirus Vaccine, Inactivated
  • Poliovirus Vaccine, Oral

Associated data